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The allure of the archives
Arlette Farge's 'Le Goût de l'archive' is widely regarded as a historiographical classic. While combining through two-hundred-year-old judicial records from the Archives of the Bastille, historian Farge was struck by the extraordinary intimate portrayal they provided of the lives of the poor in pre-Revolutionary France, especially women. She was seduced by the sensuality of old manuscripts and by the revelatory power of voices otherwise lost. In this book, she conveys the exhilaration of uncovering hidden secrets and the thrill of venturing into previously unknown dimensions of the past.
Book
Troubling Troubled Waters in Elementary Science Education: Politics, Ethics & Black Children's Conceptions of Water Justice in the Era of Flint
The study of water as a K-12 science idea often divorces its properties from its deeply politicized history as a resource that has been limited, compromised, and intentionally withheld from nondominant communities. Although a robust body of scholarship has aptly critiqued decontextualized and depoliticized pedagogies and called for critical science-learning environments designed through the lens of equity, historicity, and power, more insight is needed into how children develop in relation to these design imperatives and within sociopolitical contexts where environmental issues pose a direct threat. We report select findings from a 2-year ethnographic project that investigated Black student agency in a school with a place-based design. Specifically, we hone in on the themes of water and water justice, which inspired the development of a socio-scientific unit enacted in two 4th-/5th-grade classrooms. This unit coincided with the initial spike in public awareness around the still unresolved water crisis in Flint, MI. For this article, we situate the \"Flint\" module as an illustrative case of justice-centered science pedagogy and analyze Black students' disciplinary, affective, and sociopolitical understandings. We found that children's meaning-making shifted from individualized accounts to critical, systemic explanations of environmental justice issues. The saliency of children's affective understandings throughout the unit was also captured. We expound on these findings and conclude with a discussion of implications, particularly as it relates to the ethics and politics of developing critical scientific capacity in young children to confront lived environmental human rights issues.
Journal Article
Commentary on “Oxygen desaturations in the early neonatal period predict development of bronchopulmonary dysplasia” by Fairchild et al
Supplemental oxygen is simultaneously the best friend and worst enemy of very low birth weight (VLBW) preterm infants. Without the ability to provide supplemental oxygen, many would not survive. Studies have shown increased incidence of dangerous comorbidities such as severe necrotizing enterocolitis in those infants with lower oxygen saturation (SpO2) targets1,2 . However, oxygen exposure also leads to significant comorbidities such as retinopathy of prematurity (ROP)1,2 and bronchopulmonary dysplasia (BPD).
Journal Article
Randomised trial of azithromycin to eradicate Ureaplasma in preterm infants
ObjectiveTo test whether azithromycin eradicates Ureaplasma from the respiratory tract in preterm infants.DesignProspective, phase IIb randomised, double-blind, placebo-controlled trial.SettingSeven level III–IV US, academic, neonatal intensive care units (NICUs).PatientsInfants 240–286 weeks’ gestation (stratified 240–266; 270–286 weeks) randomly assigned within 4 days following birth from July 2013 to August 2016.InterventionsIntravenous azithromycin 20 mg/kg or an equal volume of D5W (placebo) every 24 hours for 3 days.Main outcome measuresThe primary efficacy outcome was Ureaplasma-free survival. Secondary outcomes were all-cause mortality, Ureaplasma clearance, physiological bronchopulmonary dysplasia (BPD) at 36 weeks’ postmenstrual age, comorbidities of prematurity and duration of respiratory support.ResultsOne hundred and twenty-one randomised participants (azithromycin: n=60; placebo: n=61) were included in the intent-to-treat analysis (mean gestational age 26.2±1.4 weeks). Forty-four of 121 participants (36%) were Ureaplasma positive (azithromycin: n=19; placebo: n=25). Ureaplasma-free survival was 55/60 (92% (95% CI 82% to 97%)) for azithromycin compared with 37/61 (61% (95% CI 48% to 73%)) for placebo. Mortality was similar comparing the two treatment groups (5/60 (8%) vs 6/61 (10%)). Azithromycin effectively eradicated Ureaplasma in all azithromycin-assigned colonised infants, but 21/25 (84%) Ureaplasma-colonised participants receiving placebo were culture positive at one or more follow-up timepoints. Most of the neonatal mortality and morbidity was concentrated in 21 infants with lower respiratory tract Ureaplasma colonisation. In a subgroup analysis, physiological BPD-free survival was 5/10 (50%) (95% CI 19% to 81%) among azithromycin-assigned infants with lower respiratory tract Ureaplasma colonisation versus 2/11 (18%) (95% CI 2% to 52%) in placebo-treated infants.ConclusionA 3-day azithromycin regimen effectively eradicated respiratory tract Ureaplasma colonisation in this study.Trial registration number NCT01778634.
Journal Article
Predicting the likelihood of lower respiratory tract Ureaplasma infection in preterms
ObjectiveTo develop predictive models of Ureaplasma spp lower airway tract infection in preterm infants.MethodsA dataset was assembled from five cohorts of infants born <33 weeks gestational age (GA) enrolled over 17 years (1999–2016) with culture and/or PCR-confirmed tracheal aspirate Ureaplasma status in the first week of life (n=415). Seventeen demographic, obstetric and neonatal factors were analysed including admission white blood cell (WBC) counts. Best subset regression was used to develop three risk scores for lower airway Ureaplasma infection: (1) including admission laboratory values, (2) excluding admission laboratory values and (3) using only data known prenatally.ResultsGA and rupture of membranes >72 hours were significant predictors in all 3 models. When all variables including admission laboratory values were included in the regression, WBC count was also predictive in the resulting model. When laboratory values were excluded, delivery route was found to be an additional predictive factor. The area under the curve for the receiver operating characteristic indicated high predictive ability of each model to identify infants with lower airway Ureaplasma infection (range 0.73–0.77).ConclusionWe developed predictive models based on clinical and limited laboratory information available in the perinatal period that can distinguish between low risk (<10%) and high risk (>40%) of lower airway Ureaplasma infection. These may be useful in the design of phase III trials of therapeutic interventions to prevent Ureaplasma-mediated lung disease in preterm infants and in clinical management of at-risk infants.
Journal Article
Randomized trial of azithromycin to eradicate Ureaplasma respiratory colonization in preterm infants: 2-year outcomes
BackgroundTo assess the potential impact of azithromycin treatment in the first week following birth on 2-year outcomes in preterm infants with and without Ureaplasma respiratory colonization who participated in a double-blind, placebo-controlled randomized controlled trial.MethodsRespiratory morbidity was assessed at NICU discharge and at 6, 12, and 22–26 months corrected age using pulmonary questionnaires. Comprehensive neurodevelopmental assessments were completed between 22 and 26 months corrected age. The primary and secondary composite outcomes were death or severe respiratory morbidity and death or moderate–severe neurodevelopmental impairment, respectively, at 22–26 months corrected age.ResultsOne hundred and twenty-one randomized participants (azithromycin, N = 60; placebo, N = 61) were included in the intent-to-treat analysis. There were no significant differences in death or serious respiratory morbidity (34.8 vs 30.4%, p = 0.67) or death or moderate–severe neurodevelopmental impairment (47 vs 33%, p = 0.11) between the azithromycin and placebo groups. Among all trial participants, tracheal aspirate Ureaplasma-positive infants experienced a higher frequency of death or serious respiratory morbidity at 22–26 months corrected age (58%) than tracheal aspirate Ureaplasma-negative infants (34%) or non-intubated infants (21%) (p = 0.028).ConclusionsWe did not observe strong evidence of a difference in long-term pulmonary and neurodevelopment outcomes in preterm infants treated with azithromycin in the first week of life compared to placebo.ImpactNo strong evidence of a difference in long-term pulmonary and neurodevelopment outcomes was identified at 22–26 months corrected age in infants treated with azithromycin in the first week of life compared to placebo.The RCT is the first study of 2-year pulmonary and neurodevelopmental outcomes of azithromycin treatment in ELGANs.Provides evidence that ELGANs with lower respiratory tract Ureaplasma have the most frequent serious respiratory morbidity in the first 2 years of life, suggesting that a Phase III trial of azithromycin to prevent BPD targeting this population is warranted.
Journal Article
Assessing the Environmental Drivers of Lassa Fever in West Africa: A Systematic Review
The spread of Lassa virus in West Africa is reliant on the abundance and distribution of its rodent host reservoirs. While the impact of environmental change on viral spread has been studied for many zoonotic viruses, there is still a limited understanding of how seasonal impacts, land-use conversion, and biodiversity loss influence the expansion of Lassa virus among reservoirs. This systematic review synthesizes existing research on the association between environmental variables and Lassa virus circulation in West Africa to inform future research, public health interventions, and One Health policy. We searched international and African scientific databases using a set of pre-defined search terms to obtain publications reporting on Lassa virus in West Africa between 1969 and 2023. A total of 9465 articles were retrieved from this search and 70 studies met inclusion criteria for this review. Through systematic data extraction, we identified seasonal precipitation, land-use change, and host expansion as key environmental drivers of Lassa virus in reservoir hosts; however, we also highlight notable gaps in knowledge that limit our current understanding of these complex relationships. This review underscores the need for interdisciplinary research and strategies to mitigate the impacts of environmental change on Lassa virus transmission and protect vulnerable populations in West Africa.
Journal Article
Use of car beds for infant travel: a review of the literature
Discharging neonates in a proper car safety seat is standard of care in the United States and many other countries. However, not every neonate can be safely positioned in a standard semi-upright car seat. In these cases, providers may opt for a travel device that allows the infant to lie flat, either supine or prone, known as a car bed. Minimal evidence exists to guide providers on car bed safety and help determine which infants would benefit from discharge in a car bed. In this article, we provide a comprehensive summary of existing literature on the safety of car beds for motor vehicle travel, car bed use in specific patient populations, and car beds vs. car seats for infants at risk of adverse cardiorespiratory events, including preterm infants with Hg-O2 desaturations in the car seat. We discuss recommendations for the follow-up of infants discharged in a car bed in order to safely transition back to a car seat.
Journal Article
